A newly revised training manual may be helpful to teach college students and parents to use applied behavior analysis (ABA) to help children with autism.
ABA is seen by many to be the treatment of choice for children with autism. There is a large need for research-based, low-cost, rapid training to train tutors and parents to conduct discrete trial training with children with autism. This study was designed to see if a revised version of the training book used to teach students to do this type of ABA therapy was useful. The authors found that the revised manual was good at training college students to use discrete trial training to teach three tasks to children with autism. The authors note that the college students did not really work with children with autism, but instead worked with people who acted like children with autism.
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Ayurveda for Autism Spectrum Disorder
Jan 4, 2011 by sunethriayurved...Hi everybody,
I am Dr.Prasad M, MD (Ay.), working with autistic kids from 2002 onwards. I went through the article mentioned. Let me share with you an unbiased information on the scope of Ayurveda, the age-old Indian system of Vedic medicine, in the treatment of ASD. This is based 100% on my personal experiences. Kindly see the following passages. Comments and criticisms are welcomed whole-heatedly.
Scope of Ayurveda in Autism Spectrum Disorder
Trials with Ayurvedic medicines and treatments for their efficacy in ASD are going on at various centres in India and abroad. The main advantage of ayurvedic medicine is that it has got a magazine of safe therapeutic preparations of various forms which are developed by continuous trials and rectifications over thousands of years. There are many preparations like kwatha (decoction), churna (powder), arishta (self-fermented beverage), gudika (pill), ghrtha (medicated ghee), thyla (medicated vegetable fats) etc. In recent times, many of the herbs used in Ayurveda are proven to have excellent detoxifying effect as well as free radical- scavenging potential. The therapeutic preparations like kwatha are combinations of many herbs. These combinations are originally developed on the basis of ayurvedic principles. Till recent times these formulations were not given due consideration by the western scientists. But now the picture has changed. More and more ayurvedic preparations are under their evaluation. In Ayurveda, the compounds as well as single herbs are used for different purposes of health care like pacifying vitiated functional units called doshas, eliminating excessive toxic accumulations, providing targeted nutrients to tissues, tuning the mind-body coordination, sharpening the efficacy of sense-organs, and so on. These prescriptions are based on personalised evaluation of different aspects like body constitution, doshik status, power of digestion and assimilation, status of bowel evacuation, physical strength, mental constitution, and etc which is done by experienced physicians. Mind is an important factor in the healing of any ailment. It is assumed that mind is like ghee which is held inside a pot called body. If the ghee is hot the pot also gets warmed and if the pot is hot definitely the ghee also will be hot. You cannot expect warm ghee in a cool pot and wise versa. Similarly, food is given the supreme role in the healing process as well as in the maintenance of health. It is a basic concept in Ayurveda that there is no use for any medicine if one stick on to pathya (wholesome) food (as it brings about health spontaneously) and there is no use for any medicine if one stick on to apathya (nasty) food (as there is no scope for functioning of the medicine). In the context of autism, these assumptions are extremely important and seen exceptionally beneficial.
The care of autism, as per ayurvedic principles, is based on the protocol of a three-step intervention.
Again, though the stages are generalised the execution will be personalised.
The first stage is based on medicines almost completely. Medicinal preparations like purgatives, specific formulations for de-worming, for enhancing the functions of the liver and pancreas, for enhancing the digestive fire (Agni), and for regulating the intestinal motility are used in this stage. Certain preparations meant for squeezing out heavy metals from the tissues are also used. Turmeric, garlic, curry leaves, etc are having this advantage.
Second phase is mainly comprised of massages. Traditional methods like abhyanga (hot-oil massages), udwarthana (dry powder massages), pindasweda of various types, thalapothichil, pizhichil, etc are used here. These manoeuvres improve the muscle tone, reduce hyperactivity, create better motor coordination, and normalize most of the obsessive repetitive movements. Child sleeps well. The bowels become more regular at this stage. He/she will be more receptive to commands or suggestions. The demand for sensory stimulation slows down considerably and the symptoms like increased sensitivity to certain sounds (hyperacusis) slowly disappear. There will be oral medications parallel to the therapies and a few of these medications will be carried over to the next phase as well.
Third stage is very specific and sold not be started before the proper completion of the first two. This is an important point as there is a general tendency to mark the condition as mental retardation and to prescribe brain tonics and memory boosters to all autistic kids indiscriminately.
The major therapies in this stage are shirodhara (pouring of liquids like oils on the head), shirovasthi (holding of medicated oils on the head inside specially designed leather-rims), shiropichu (wetting the scalp with oil bandages), dhoopanam (fumigation with specific medicines) etc along with specific medications like kallyanakam kashayam, indukantham kashayam, gorochanadi gudika,balakanakapathradi kashayam, sidharthakam gudika etc. Certain specific herbs like sahadevi, sankhapushpi, vacha, vishnukranthietc are also used. Follow up is done with ghee preparations like mahakallyanaka, mahapaisachika, brahmighrtha, saraswathaghrtha, etc.
Conclusion
It is seen that the classical ayurvedic treatment done systematically give promising results in kids diagnosed with ASD. But it should be emphasised that the level of improvements is different from child to child. Another important point is that these interventions are made in a corrective manner. The child gets relieved of a lot of physical problems and tantrums. But this will not make him/her a normal child. Intensive training and special education are needed to put him on track and to catch up the peers. This requires the dedicated involvement of parents, special educators, and skilled professional like occupational therapists.
Scope of Ayurveda in ASD by Vaidya Prasad
Nov 13, 2009 by AnonymousTrials with Ayurvedic medicines and treatments for their efficacy in ASD are going on at various centres in India and abroad. The main advantage of ayurvedic medicine is that it has got a magazine of safe therapeutic preparations of various forms which are developed by continuous trials and rectifications over thousands of years. There are many preparations like kwatha (decoction), churna (powder), arishta (self-fermented beverage), gudika (pill), ghrtha (medicated ghee), thyla (medicated vegetable fats) etc. In recent times, many of the herbs used in Ayurveda are proven to have excellent detoxifying effect as well as free radical- scavenging potential. The therapeutic preparations like kwatha are combinations of many herbs. These combinations are originally developed on the basis of ayurvedic principles. Till recent times these formulations were not given due consideration by the western scientists. But now the picture has changed. More and more ayurvedic preparations are under their evaluation. In Ayurveda, the compounds as well as single herbs are used for different purposes of health care like pacifying vitiated functional units called doshas, eliminating excessive toxic accumulations, providing targeted nutrients to tissues, tuning the mind-body coordination, sharpening the efficacy of sense-organs, and so on. These prescriptions are based on personalised evaluation of different aspects like body constitution, doshik status, power of digestion and assimilation, status of bowel evacuation, physical strength, mental constitution, and etc, which is done by experienced physicians. Mind is an important factor in the healing of any ailment. It is assumed that mind is like ghee, which is held inside a pot called body. If the ghee is hot the pot also gets warmed and if the pot is hot definitely the ghee also will be hot. You cannot expect warm ghee in a cool pot and wise versa. Similarly, food is given the supreme role in the healing process as well as in the maintenance of health. It is a basic concept in Ayurveda that there is no use for any medicine if one stick on to pathya (wholesome) food (as it brings about health spontaneously) and there is no use for any medicine if one stick on to apathya (nasty) food (as there is no scope for functioning of the medicine). In the context of autism, these assumptions are extremely important and seen exceptionally beneficial.
The care of autism, as per ayurvedic principles, is based on the protocol of a three-step intervention.
Again, though the stages are generalised the execution will be personalised.
The first stage is based on medicines almost completely. Medicinal preparations like purgatives, specific formulations for de-worming, for enhancing the functions of the liver and pancreas, for enhancing the digestive fire (Agni), and for regulating the intestinal motility are used in this stage. Certain preparations meant for squeezing out heavy metals from the tissues are also used. Turmeric, garlic, curry leaves, etc are having this advantage.
Second phase is mainly comprised of massages. Traditional methods like abhyanga (hot-oil massages), udwarthana (dry powder massages), pindasweda of various types, thalapothichil, pizhichil, etc are used here. These manoeuvres improve the muscle tone, reduce hyperactivity, create better motor coordination, and normalize most of the obsessive repetitive movements. Child sleeps well. The bowels become more regular at this stage. He/she will be more receptive to commands or suggestions. The demand for sensory stimulation slows down considerably and the symptoms like increased sensitivity to certain sounds (hyperacusis) slowly disappear. There will be oral medications parallel to the therapies and a few of these medications will be carried over to the next phase as well.
Third stage is very specific and sold not be started before the proper completion of the first two. This is an important point as there is a general tendency to mark the condition as mental retardation and to prescribe brain tonics and memory boosters to all autistic kids indiscriminately.
The major therapies in this stage are shirodhara (pouring of liquids like oils on the head), shirovasthi (holding of medicated oils on the head inside specially designed leather-rims), shiropichu (wetting the scalp with oil bandages), dhoopanam (fumigation with specific medicines) etc along with specific medications like kallyanakam kashayam, indukantham kashayam, gorochanadi gudika, balakanakapathradi kashayam, sidharthakam gudika etc. Certain specific herbs like sahadevi, sankhapushpi, vacha, vishnukranthi etc are also used. Follow up is done with ghee preparations like mahakallyanaka, mahapaisachika, brahmighrtha, saraswathaghrtha, etc.
It is seen that the classical ayurvedic treatment done systematically give promising results in kids diagnosed with ASD. But it should be emphasised that the level of improvements is different from child to child. Another important point is that these interventions are made in a corrective manner. The child gets relieved of a lot of physical problems and tantrums. But this will not make him/her a normal child. Intensive training and special education are needed to put him on track and to catch up the peers. This requires the dedicated involvement of parents, special educators, and skilled professional like occupational therapists.
Yummy Food or Yucky Food
Sep 11, 2008 by AnonymousOne Person's Yummy Food Is Another Person's Yucky Food
Vegetables and protein (fish, poultry, meats, and beans) are the most common food aversions. Some children even reject fruits. The diet becomes extremely restricted to bland, white foods, including sweets, breads, pasta, crackers, pretzels, chips, and macaroni and cheese. These foods are glycemic and raise blood glucose, quickly increasing the demand for insulin production. Zinc is part of the insulin molecule and is depleted, resulting in abnormal taste and taste perception. What develops is an aversion to the flavors in natural foods and increased cravings for highly sweetened foods and those foods containing MSG. (MSG affects the brain's perception of flavor.) The diet becomes more narrow, and nutritional status declines, resulting in more limited food choices. The white diet and vegetable aversion is common among children in Western cultures due to the high exposure to processed and sweet foods. For children with sensory and developmental issues, the aversions are much more pervasive and serious.
There are three potential contributors that lead to the limited appetite, cravings, and food aversions:
The negative effect of this combination can result in faulty messages from the sensory receptors to the brain and dysfunctional interpretation of those messages by the brain. Perception is the "truth" for that person. This is why begging, bribing, and punishing do not and will not work.
The solution is multifaceted. Correction of nutritional deficiencies and elimination of toxic metals are mandatory and involve appropriate therapeutic supplementation based on findings. Foods that cause reactions and/or opiate-like peptides need to be eliminated as healthy, safe foods are introduced and accepted.
How to Go from Yucky to Yummy-The Trojan Horse Technique
For those with texture issues, it is important to adapt the diet to the child's oral and food developmental stage. If textures are a sensory issue, no matter how tasty the food, it will not be consumed. By providing the food in a sensory-pleasing form, the child benefits nutritionally and begins to find mealtime more pleasant and rewarding. Purees are generally helpful. They are better tolerated and can open the door for getting more types of foods into the diet. Many family dishes, including soups, casseroles, or the meat and vegetable main dish, can also be served pureed for the child who has sensory texture issues. In this way, the whole family is enjoying the same meal.
Many of the recipes in this book have been selected to expand nutritional intake, especially using the Trojan Horse Technique-hiding a small amount of the new food (especially vegetables and proteins) within a very well tolerated and acceptable food. Each child differs and, therefore, it is important to identify what foods will work as "carriers" to get the new foods in.
Purees can be made from cooked fresh or frozen vegetables and/or purchased baby foods. If your child is offended by being served baby food, simply keep it well hidden. Create interesting new names for the foods and see that others in the family join in consuming them. The secret to success in introducing these new foods is to combine a small amount with the food the child already likes. For many children, this is the only way new foods can be introduced.
Start with 1 tablespoon (15 g) or less-and then increase when tolerated. Hide the cooked vegetable purees anywhere you can, selecting colors that are not obvious when added to the carrier food. The carrier food needs to be one that the child enjoys. It may even be a food that is being slowly eliminated. Include pureed fruits to improve the taste. Here are some examples of places to hide foods (and even supplements):
The above is an excerpt from the book The Kid-Friendly ADHD & Autism Cookbook: The Ultimate Guide to the Gluten-Free, Casein-Free Diet
by Pamela J. Compart, M.D. and Dana Laake, R.D.H., M.S., L.D.N.
Published by Fair Winds Press; November 2006;$24.95US/$32.50CAN; 978-1-59233-223-6
Copyright © 2008 Pamela J. Compart, M.D. and Dana Laake, R.D.H., M.S., L.D.N
Author Bio
Pamela J. Compart, M.D., is a developmental pediatrician in Columbia, Maryland. She combines traditional and complementary medicine approaches to the treatment of ADHD, autism, and other behavioral and developmental disorders. She is also the director of HeartLight Healing Arts, a multidisciplinary integrated holistic health care practice, providing services for children, adults, and families.
Dana Godbout Laake, R.D.H., M.S., L.D.N., is a licensed nutritionist in Kensington, Maryland. Within her practice, Dana Laake Nutrition, she provides preventive and therapeutic medical nutrition services. Her practice includes nutritional evaluation and treatment of the full spectrum of health issues affecting adults and children with special needs.
School Lunches for Kids with ASD
Sep 11, 2008 by AnonymousSCHOOL LUNCHES FOR KIDS WITH ASD: DELICIOUS, HEALTHY & POSSIBLE.
THE CHALLENGE:
With only twenty minutes to eat, kids with autism spectrum disorder (ASD) should have "fast" foods that are healthy, tasty, loaded with nutrients and free of the culprits that are common problems: gluten, milk products, soy, and artificial additives and coloring. Add to the list sensory issues involving food texture, color and taste along with unusually picky appetites so common in ASD - and the task seems insurmountable. Beyond the challenges with foods are the safety issues of the food containers themselves, especially plastics containing phthalates and bisphenyl A (BPA). And of course there is the "cool" factor which affects pre-school through high school. Food that is different is totally uncool for kids who already face so many social and learning stigmas.
Knowing the challenges, we can now focus on the solutions.
THE SOLUTIONS:
Basics
As is the case with any meal, there are some basics to follow. Blood sugar control is critical. All people are affected by rapidly rising blood sugar which then cascades down too quickly and too low. The most noticeable effects are on brain function especially mood and attention. As the blood sugar drops too quickly, there can be irritability, hunger headaches, lack of focus, behavior problems, and cravings for a "quick sugar fix" which keeps the cycle going. This interferes with learning and can be disruptive to the class. Protein and fiber stabilize blood sugars. Below is a summary of the basic rules for any meal including school lunch.
Assumptions
All food suggestions are GFCF (gluten-free, casein-free). Glutens include wheat, oat, barley, rye, spelt and kamut. Milk products and milk casein include milk, yogurt, cheese, creams, ice cream, cream sauces, and butter.
Avoids
Glycemic foods which raise blood sugar (glucose) quickly include: sugars, sodas of any kind, candy, sweets, juices, and any refined grains (pretzels, bread, crackers, bagels, chips) on an empty stomach. Limit the sugars and keep the refined carbohydrates limited. If small amounts are consumed at the end of the meal, the negative effect is less.
A word on sodas - both regular and diet. They have no place in a healthy diet. They are high in phosphorus which depletes healthy nutrients. Consider them removers of electrolytes, not drink options. Water is best, but other good choices include: dilute juices, seltzer water with juice to flavor, vegetable juices (V8)
Promote Protein at every meal or snack
Choices include fish, poultry, meat, eggs, beans, nuts and seeds.
Avoids: milk products
The serving size for protein for each person is the size of the palm. A child's may be 1 to 2 ounces of meat/chicken/fish and a teen and adult may be 3 to 5 ounces. See the chart for guidelines
For beans, the serving size is two cupped palms full. See the chart for guidelines.
Fabulous Fiber at every meal
Choices include fruits, beans, nuts, seeds and grains.
Avoid: glutens
If your child eats very few vegetables, fruits, grains, nuts, seeds and beans, added fiber is important. Fiber as pure guar gum is easy to add to any recipe and also to drinks. It is GFCF and more fine than sugar, mixing completely in water or juice. See the table for fiber intake suggestions.
Favorite Foods at every meal or snack
Include at least one food that is a favorite in order to promote more interest in the meal.
Fun Meals - Part of the Cool Factor
Take a tip from the fast food marketers and include a surprise gift in the lunch. It might be a small collectible such as cars, baseball cards, characters, hair clips, stickers, or child's ring or bracelet. Home made "giftlets" (tiny gifts) are perfect.
Guidelines and Ideas
Go organic as much as possible. "USDA Organic" means the food is produced without the use of harmful pesticides, artificial fertilizers, antibiotics, growth hormones human waste, or sewage sludge, and that they were processed without ionizing radiation or food additives. Children with ASD are already coping with their own excess metabolites and really can not handle the burden of harmful chemicals in the environment and foods. The less the exposure the better. Anything you can do for your child is a benefit.
There are numerous resources for GFCF foods and recipes online and in many books. Utilize all of these to find the commercially available foods your child will eat as well as recipes that are not just GFCF, they are nutritious and delicious. Test them at home - not in the school lunch. There are GFCF juice boxes, pretzels, breads, wraps and snacks.
Establish three to five basic lunches that work. If your child is willing and interested, engage him or her in the process. Test new foods out at home until you have the food right and the combination of foods right.
Use freezer packs for keeping foods cold and thermos for hot foods. Include non-toxic hand sanitizers which are commercially available (avoid the commercial sanitizers). You can also send two paper towel pieces - one moistened with soap and one moistened with water..
Packaging - a good opportunity to Go Green!
Again - go with the marketers - jazz it up! Select a lunch container your child loves. Young children love to decorate a lunch box with stickers and paints. Make the lunch box the child's own work of art personalized with a name. Reusable containers and boxes are the green way to go. Older children will definitely want to select whatever is considered cool. The most cool may be a paper bag or small recycled bag carried in a back pack. Go with the trend and your child's own choice. There are companies who make safe, BPA-Free, safe lunch box sets with inserts for the different foods.
To avoid plastic wraps for sandwiches, use wax paper or parchment paper. Avoid containers with BPA by avoiding items with the recycle number 7. There are many BPA -Free containers which can be washed and reused. Your child will need to know to bring these back home rather than throw them away.
For napkins, use washable cloth napkins or dishcloths, or choose processed chlorine-free (PCF), post-consumer-waste (PCW) paper napkins available in stores and on line. If utensils are needed, use stainless steel appropriate to the child's skill level and age.
Nutritious Can Be Delicious - Even for the Picky Eater - The Trojan Horse Technique
Remember Odysseus from seventh grade mythology? Seeking to gain entrance into Troy, he cleverly ordered a hollow wooden horse so large that the Greek army could hide inside. What looked like a huge horse was really a disguise to conquer the city. We have used this concept for decades to hide nutritious food to nourish picky eaters.
Rather than introduce a new food in its natural form, begin by hiding a very small amount (about a tablespoon) of it as puree mixed or blended into a well-liked and well-tolerated food. This approach allows the body to accept the new food. As the child accepts the taste, include more. Children who have food texture issues are especially good candidates for blended foods because their sensory development may be younger than their chronological age. Adapt to the sensory level and return to purees until sensory issues improve. Rather than focusing on getting a child to tolerate foods that he perceives as "lumpy" or unpleasant to chew, the goal is getting a child to eat nutritious food, however you can.
Match the Color and Texture
Assume the new food is a vegetable, use organic baby food purees or make your own. Puree the new food into an established food that does not change the overall color, texture, smell, or taste. If a child eats nothing but white food, start with very light-colored vegetables including squash, cauliflower and corn. If the child likes ketchup or tomato sauce, then introduce deeper-colored vegetables such as beets, greens, peas and beans. Pureed vegetables can be beaten into batter for pancakes, muffins, brownies, and cookies or into tomato and other pasta and pizza sauces, and even into ketchup.
Mix Fruits and Vegetables
Vegetable juice makes a healthy addition to fruit juice. Try mixing carrot juice with orange juice, and then adding a teaspoon or so of another vegetable juice. Serve in a brightly colored sippy cup to camouflage any color changes. Blend pureed vegetables into cooked fruits such as applesauce or pearsauce, into meatballs, and even into nut butters. Expand ideas as tolerance improves. Be sure to carry out the Trojan Horse technique out of the sight of your child!
Muffin Casseroles
Many families have developed what we call muffin casseroles. One resourceful mother developed a GF/CF muffin for her child who ate only breads and muffins, and then gradually added fruit puree to the batter. As he tolerated fruits, she moved to vegetable purees, and finally added pureed meat. Until he was able to transition to eating foods in a traditional manner, he ate his muffin casseroles at every meal and snack-and loved them!
Increase Protein
The Trojan Horse technique is especially useful for kids who need more protein in their diets. Add eggs, especially the high-protein whites, and rice-protein powders to batters, breads, smoothies, meat sauces and meatballs. Do not add raw eggs to smoothies.
Gradually Move On
AS your child expands to eating vegetables, try vegetables dipped in honey or mayo/ketchup mix or hommus. It is a start . As a child accepts an increasing number of foods presented in a sneaky manner, eventually, he/she will accept the food alone - we promise! All it takes is patience, and a lesson from Greek mythology!
Choose one from each section. This list is GFCF. Also avoid any foods which provoke reactions or those forbidden at school (nuts for examples) or foods The "Other" section is optional.
Some Protein Choices: chicken strips, GFCF chicken nuggets w/ketchup to dip, meat slices rolled up, shrimp (send frozen, will thaw by lunch) w/seafood sauce to dip, organic "deli" chicken slices, hommus plain, on bread or crackers or as dip for veggies, muffin "pot pies", soy yogurt, egg salad, hard boiled eggs or deviled eggs, peanut butter on crackers or apples, nuts - all varieties - almonds, cashews, pecans, pistachios, hazelnuts. Hot food for thermos: chili or soups, turkey hot dogs cut up, GFCF pizza.
Some Vegetables & Fruit Choices: These can be eaten plain or dipped in GFCF sauces, ketchup or honey. Foods include: cup of vegetables, baby carrots or carrot strips, broccoli "trees", apples, bananas, berries, oranges, peaches, grapes, pineapple, melon, natural fruit cocktail in natural juice, raisins, apricots, applesauce in cups, any blended fruit sauce.
Drink Choices: water, fruit juice, V8, V8+fruit, seltzer w/juice, fruit smoothie, other milk (soy, rice, coconut, almond), and keep drinks partially frozen so they will remain cold.
Other: GFCF pretzels, rice crackers, baked tortilla chips, GFCF dry cereal, GFCF vegetable gummies, small GFCF cookie.
The above is an excerpt from the book The Kid-Friendly ADHD & Autism Cookbook: The Ultimate Guide to the Gluten-Free, Casein-Free Diet
by Pamela J. Compart, M.D. and Dana Laake, R.D.H., M.S., L.D.N.
Published by Fair Winds Press; November 2006;$24.95US/$32.50CAN; 978-1-59233-223-6
Copyright © 2008 Pamela J. Compart, M.D. and Dana Laake, R.D.H., M.S., L.D.N
Author Bio
Pamela J. Compart, M.D., is a developmental pediatrician in Columbia, Maryland. She combines traditional and complementary medicine approaches to the treatment of ADHD, autism, and other behavioral and developmental disorders. She is also the director of HeartLight Healing Arts, a multidisciplinary integrated holistic health care practice, providing services for children, adults, and families.
Dana Godbout Laake, R.D.H., M.S., L.D.N., is a licensed nutritionist in Kensington, Maryland. Within her practice, Dana Laake Nutrition, she provides preventive and therapeutic medical nutrition services. Her practice includes nutritional evaluation and treatment of the full spectrum of health issues affecting adults and children with special needs.